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Percutaneous Transhepatic Biliary Drainage in the Management of Post-surgical Biliary Leaks

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Abstract

The aim of this study was to evaluate the efficacy of percutaneous transhepatic biliary drainage (PTBD) in the treatment of post-surgical biliary leaks and its efficacy in restoring the integrity of bile ducts. One hundred and fifty-seven patients with a post-surgical biliary leak were treated by means of percutaneous transhepatic biliary drainage. The biliary leak was due to laparoscopic procedures in 114 patients, while 43 patients had postoperative leak following open surgery. Percutaneous transhepatic biliary drainage was performed with an 8- to 10-F catheter, with the side holes positioned proximal to the site of extravasation to divert bile flow away from the leak site. The established biliary leaks at the site of origin were diagnosed at an average of 7 days (range 2–150 days) after surgery. In all cases, percutaneous access to the biliary tree was achieved. In 62 patients, biliary leak completely healed after drainage for 10–50 days (mean, 28 days) while 89 patients underwent surgical reconstruction subsequently. PTBD is a feasible, effective, and safe procedure for the treatment of post-surgical biliary leaks. It is therefore a reliable alternative to surgically repair smaller biliary leaks, while in patients with large defects, it helps prepare patients for surgical reconstruction.

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References

  1. Czerniak A, Thompson JN, Soreide O, Benjamin IS, Blumgart LH (1988) The management of fistulas of the biliary tract after injury to the bile duct during cholecystectomy. Surg Gynecol Obstet 167:33–38

    CAS  PubMed  Google Scholar 

  2. Liguory C, Vitale GC, Lefebre JF, Bonnel D, Cornud F (1991) Endoscopic treatment of postoperative biliary fistulae. Surgery 110:779–784

    CAS  PubMed  Google Scholar 

  3. Sherman S, Shaked A, Cryer HM, Goldstein LI, Busuttil RW (1993) Endoscopic management of biliary fistulas complicating liver transplantation and other hepatobiliary operations. Ann Surg 218:167–175

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Smith AC, Schapiro RH, Kelsey PB, Warshaw AL (1986) Successful treatment of nonhealing biliary-cutaneous fistulas with biliary stents. Gastroenterology 90:764–769

    Article  CAS  PubMed  Google Scholar 

  5. Vaccaro JP, Dorfman GS, Lambiase RE (1991) Treatment of biliary leaks and fistulae by simultaneous percutaneous drainage and diversion. Cardiovasc Intervent Radiol 14:109–112

    Article  CAS  PubMed  Google Scholar 

  6. Kaufman SL, Kadir S, Mitchell SE et al (1985) Percutaneous transhepatic biliary drainage for bile leaks and fistulas. AJR 144:1055–1058

    Article  CAS  PubMed  Google Scholar 

  7. Goldin E, Katz E, Wengrower D et al (1990) Treatment of fistulas of the biliary tract by endoscopic insertion of endoprostheses. Surg Gynecol Obstet 170:418–423

    CAS  PubMed  Google Scholar 

  8. Hoffman BJ, Cunningham JT, Marsh WH (1990) Endoscopic management of biliary fistulas with small caliber stents. Am J Gastroenterol 85:705–707

    CAS  PubMed  Google Scholar 

  9. Branum G, Schmitt C, Baillie J et al (1993) Management of major biliary complications after laparoscopic cholecystectomy. Ann Surg 217:532–541

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Lee CM, Stewart L, Way LW (2000) Postcholecystectomy abdominal bile collections. Arch Surg 135(5):538–542

    Article  CAS  PubMed  Google Scholar 

  11. Zuidema GD, Cameron JL, Sitzmann JV et al (1983) Percutaneous transhepatic management of complex biliary problems. Ann Surg 197:584–593

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Saad N, Darcy MD (2008) Iatrogenic bile duct injury during laparoscopic cholecystectomy. Tech Vasc Interv Radiol 11(2):102–110

    Article  PubMed  Google Scholar 

  13. Covey AM, Brown KT (2008) Percutaneous transhepatic biliary drainage. Tech Vasc Interv Radiol 11(1):14–20

    Article  PubMed  Google Scholar 

  14. Perini RF, Uflacker R, Cunningham JT, Selby JB, Adams D (2005) Isolated right segmental hepatic duct injury following laparoscopic cholecystectomy. Cardiovasc Intervent Radiol 28(2):185–195

    Article  PubMed  Google Scholar 

  15. Cozzi G et al (2006) Percutaneous transhepatic biliary drainage in the management of postsurgical biliary leaks in patients with nondilated intrahepatic bile ducts. Cardiovasc Intervent Radiol 29:380–388

    Article  PubMed  Google Scholar 

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Correspondence to Krantikumar Rathod.

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Popat, B., Thakkar, D., Deshmukh, H. et al. Percutaneous Transhepatic Biliary Drainage in the Management of Post-surgical Biliary Leaks. Indian J Surg 79, 24–28 (2017). https://doi.org/10.1007/s12262-015-1418-1

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  • DOI: https://doi.org/10.1007/s12262-015-1418-1

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